Agenda item

Graeme Betts, Interim Director, Adult Social Care,  to present

Profession Graeme Betts, Interim Director of Adult Social Services, gave the following powerpoint presentation on Adult Social Care Services:-

 

Changes in Adult Social Care Nationally – from Dependency to Resilience

-          From institutions to community and home-based services

-          Improvements in supporting people to live their lives independently

-          Greater use of information and advice, one-off interventions and advocacy

-          Greater focus on prevention, early intervention, rehabilitation, recovery and reablement and enablement

-          Greater use of housing-based support, telecare and other technologies

-          Focus on supporting carers

-          Greater use of personal budgets to increase choice and control

-          Better joint working with the NHS

 

The Challenges facing Adult Social Care

-          Demography

In Health there was a gradual increase in the spending on people as they got older

In Care, the costs were reasonably low until the age of 85 when the costs then soared

Rotherham’s population was declining with regards to its younger adults – these were the ones that provided informal care to older people

 

-          Expectations

 

-          Quality Standards

There had been an incredible rise in the standards of residential care but it came at a cost

 

-          Safeguarding

Agencies were better at identifying the level of emotional, physical and financial abuse – again at an increased cost

 

-          Resources

Net expenditure of approximately £70M

Over the past 3 years the Authority had had to make £14M savings

Rotherham Adult Social Care Services was a high spender

 

Headline Figures 2014/15

-          Over 6,400 people had received a Service during the year (excluding Occupational Therapy only Services)

-          Approximately 4,000 Social Care Assessments or re-assessments were undertaken during the year

-          90% of Service users on Service for more than a year received a review of their needs

-          1,700 adults and older people placed in residential and nursing care

 

Pyramid of Care

-          Contact received during the year with the outcome

Service Cost £371,517

Age 18-64 – 889

Age 65+ - 1,828

 

-          In long term Community-based Service

Service Cost £22,399,007

Age 18-64 – 2,051

Age 65+ - 2,204

 

-          Residential/Nursing Service

Service Cost £22,139,903

Age 18-64 – 234 (Residential 195 and Nursing 39)

Age 65+ - 1,462 (Residential 1,090 and Nursing 372)

 

Connect to Support Rotherham

-          A website for adults in Rotherham who needed support to live independently

-          The website offered information and advice and was also an e-marketplace offering 1,905 products and 414 services

-          Generated an average 800 hits a month

-          www.connectosupport.org/rotherham

-          Self-serve and channel shift

-          Dependence to Independence

-          Preventative

-          Supported the Care Act through advice and information

-          Had the potential to be further developed to provide personalised guidance, self-assessment, financial assessment, care accounts, support planning and more

 

Shared Lives

-          Shared Lives offered opportunities for vulnerable adults to live or spend time with approved carers and their families

-          This could be for a few hours or a few days a week (befriending), short stays in the home of the Shared Lives carer or living as a member of their family

-          There were over 50 users of the Service.  Currently all long term and respite users had a learning disability.  Befriending was mostly used by older people and/or people with dementia or physical difficulties

-          Carers were approved and supported by Shared Lives Workers and received fees and expenses.  Shared Lives was registered with the Care Quality Commission

-          Person-centred and was cost effective

 

Changes to Eligibility Criteria

-          A new national Eligibility Framework – a single, consistent route to determining people’s entitlement to care and support

-          Based on principles of wellbeing

-          Assessment to be based on ‘strengths’ instead of deficits and to be asset based

-          Portability of assessments

-          National consultation being undertaken by the Department of Health

-          Shift from Dependence to Independence

 

Delivering Adult Social Care in the Future

-          Resilient residents accessing mainstream services

-          Focus on prevention, enablement and support for carers

-          Personalised services with high use of direct payments

-          Strong commissioning function

-          Well-developed market for social care maximising choice and control

-          Wide range of micro-enterprises, Personal Assistants and Shared Lives Schemes

-          Strong partnerships with Health and the third sector

-          Well-developed co-production and co-delivery with users, carers and residents underpinning all of this

 

Discussion ensued with the following issues raised/clarified:-

 

·           The Integrated Mental Health Services was not operating as well as it should and work was taking place with Doncaster and North Lincolnshire who worked with RDaSH.

 

·           The Learning Disability Service was an area that was being looked at in more detail particularly with regard to integration.

 

·           Following Winterbourne, were there any safeguards in place to ensure people with learning disabilities or mental health issues were protected and supported? 

An assurance was given that Winterbourne was taken very seriously in Rotherham and there was a whole programme to ensure Services knew where people were in the system and what the plans were for them.  That is being handled well .

 

·           There was no mention of dignity which was something that quite often was omitted?

Dignity went hand in hand with independence and was at the heart of everything the Service did.

 

·           As the criteria had changed nationally and was now based on substantial and critical needs, an individual’s needs may increase which have an effect on Services.  Was an increase anticipated?

As a result of the Care Act, it was anticipated that the introduction of assessments for carers would see an increase in the workload together with self-funders being able to now request an assessment even though they may not get access to funding from Rotherham. 

 

·           More people were living longer and encouraging them to stay in their own homes caused a housing problem further down the line.  However, if they moved into more appropriate housing that was not solving the problem as you would wish them to stay in an environment that was familiar to them

Housing was a challenge.  The Authority had a Housing Strategy for Older People which we Adult Social Care would be feeding into.  It needed to take account of the fact that people were living longer and on their own more.  There was a project called “happy” project which basically looked at housing suitable for older people rather than older people’s housing and the idea that people moved much earlier in their lives. 

 

·           The Shared Lives Scheme was a great initiative but had not really been very successful in Rotherham

The Project Manager had been requested to draw up a 3 year growth plan.  It was felt that Rotherham had huge potential for Shared Lives.

 

·           If Shared Lives was successful it would result in significant financial savings.  Would they be reinvested in the Adult Social Care budget? 

There were areas that needed to be reinvestment.  Overall the Council would have to meet its budget responsibility as well as careful consideration given to what was invested in. 

 

·           There was an issue around the transition of young people into Adult Social Care particularly within the wider integration agenda.  What current work was taking place? 

The Director of Children’s Services had attended a meeting of the Adult Social Care Management Team to discuss how to improve integration.  A meeting was to take place shortly with Commissioner Manzie regarding the overall commissioning and the issue of whether there should be commissioning and Service provision across the lifecourse and a much more integrated approach from cradle to grave.  Work was taking place on making Services more integrated and giving residents a better service. 

 

·           Personal budgets in terms of independence were really great but what were they based on?  Were there any statistics?

A number of residents had been met who had personal budgets, Direct Payments etc. to discuss the quality of services.  The feedback was that the Authority needed to do more but the message was very much that Direct Payments had given them their lives back.  Quite often it was the most complex cases that a Direct Payment could make sense of how they ran their lives.  However, the Service did not do enough and needed to look at why.

 

·           The Connect to Shared Lives website received 800 hits a month but how did that translate into takeups? 

It was not known at the present time but it would be looked into.

 

Resolved:-  (1)  That the presentation be noted.

 

(2)  That further liaison with Adult Social Care take place to assist in developing the work programme.